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The first results of the government’s new NHS friends and family test should be treated with caution because of the huge variation in response rates, commentators have warned.

The test, which asks patients whether they would recommend their hospital ward or accident and emergency department to their friends and family, has been hailed by the government as a “game changer” in giving patients a stronger voice in deciding whether their care is good enough or not—and to encourage hospitals to make improvements.

The first results, published on 30 July, showed that inpatient services were more highly recommended than accident and emergency services, while specialist hospitals tended to have higher scores for inpatient services.1

In June, just 36 hospital wards out of 4500 across the country scored an overall negative figure, down from 66 in April. For accident and emergency in June, just one service received a negative score.

The results were gathered from 400 000 patients in April, May, and June 2013.

But despite much government fanfare, critics have raised concerns about whether …